After four years of research by Maastricht University and RIVM into the acute harmfulness of heated tobacco products for the heart and blood vessels and lungs, it can be said with certainty: heated tobacco products are harmful to health.

By the web editors

Heated tobacco products (HTPs) are harmful to health, just like traditional cigarettes. PhD research by the Italian biotechnologist Michele Davigo, affiliated with Maastricht University, shows that heated tobacco products are harmful to health in the short term, especially to the heart and blood vessels and lung function. The longer-term effects have yet to be demonstrated. The conclusions of the study, which was carried out in collaboration with the National Institute for Public Health and the Environment (RIVM), mean that RIVM is now even more emphatic than before about heated tobacco. In a news item about the PhD research, the institute writes: “This means that heated tobacco products are not a safe alternative to smoking. The use of these products should therefore be strongly discouraged, as with regular cigarettes.”

For the study, Davigo and fellow researchers from Maastricht University, RIVM and the Netherlands Food and Consumer Product Safety Authority (NVWA) first conducted a literature study. For that study, published in Inhalation Toxicology, 74 independent studies were analysed. That analysis concluded that emissions from heated tobacco products contain lower concentrations of tobacco-related toxins than cigarette smoke, but higher levels of other toxins. It was also concluded that the use of heated tobacco has a direct effect on the heart, blood vessels and lungs.

Iqos use leads to DNA damage

The latter has been demonstrated again in Davigo’s PhD research by measuring the physical reactions of test subjects who use heated tobacco products from Philip Morris (Iqos) or cigarettes, compared to non-users. The smokers of heated tobacco show the same reactions of exposure and damage, such as increased heart rate and increased blood pressure. Subsequently, epithelial cells from bronchi and lungs were also exposed to the emissions from heated tobacco and cigarettes in the laboratory. Among other things, DNA damage and effects on genes were established. There are also indications that the use of heated tobacco can lead to COPD.

The dissertation’s conclusion therefore ends with the observation: “Moreover, our results demonstrate the need to ban the tobacco industry claims over HTPs and suggest policy makers to properly inform the society about the potential risks associated with use of HTPs while enforcing restrictive measures over the spread of these products, particularly among youth generations.”

Acute effects similar to cigarette

In the broadcast on Dutch television of consumer programme Kassa on 7 February, Davigo’s co-supervisor Reinskje Talhout, researcher at RIVM and special professor of Product Attractiveness and Prevention of Harmful Consumption Behaviour at Wageningen University & Research, says: “We have done research for four years and we can now really conclude that this is not a safe alternative to cigarettes. An important conclusion is that the acute effects on cardiovascular disease are just as strong for smokers as for users of the product.”

Pulmonary pathologist at the LUMC Daniëlle Cohen says in the programme that she is happy with the research, because it was carried out independently of the tobacco industry and now tells ‘the true story’, “namely that it is a harmful product”. The intricate network of alveoli and capillaries in the lungs is only intended for breathing clean air, she explains. One of the outcomes that worries Cohen the most is that it has now been shown that heated tobacco also causes DNA damage, “and that is the basis for the formation of cancer. So, I fear that in ten, twenty years, if people are going to use this for years, I will see tumours, cancer, because of these products.”

Cohen is also concerned about the evidence of the development of COPD and about the nicotine in these products that makes them as addictive as all other nicotine products. She calls the fact that tobacco companies such as Philip Morris are talking about a ‘smoke-free future’ pure deception, because it may seem that they have the same goal in mind as doctors and health organizations that strive for a smoke-free generation, but in fact only strive for more products sold.

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